Surveillance

Now that India is close to reaching the elimination of visceral leishmaniasis, it will be key to have strong and well-functioning surveillance system in place in order to detect a potential increase in cases in a timely matter and react accordingly. Moreover, certain specific subgroups of the disease, in particular asymptomatic infection, post kala azar dermal leishmaniasis (PKDL) and VL-HIV co-infection, will become increasingly important because of their potential to trigger a resurgence, and should hence be included in the surveillance system.

In this study we will develop and evaluate a set of surveillance measures to be implemented at eight existing Primary Health Care centres (PHCs) in the four most affected states of India, with special attention to active case finding of HIV-VL co-infection and PKDL. We will also conduct sero-surveys with DAT and rK39 antibodies tests in six villages in VL endemic and non-endemic areas to know whether serological surveys can distinguish endemic areas from areas without transmission, and whether such surveys can be used to monitor trends in transmission intensity over time. During this study we will evaluate the feasibility within the existing health system as well as costs made. At the end of this study we hope to be able to provide a validated surveillance tool that can be realistically implemented in the Indian health system in order to monitor visceral leishmaniasis in the post-elimination phase. 

Hasker E, Malaviya P, Scholar VK, de Koning P, Singh OP, Kansal S, Cloots K, Boelaert M, Sundar S. (2019). Post kala azar dermal leishmaniasis and leprosy prevalence and distribution in the Muzaffarpur health and demographic surveillance site. PLoS Neglected Tropical Disease. 25;13(10):e0007798.

Chakravarty J, Hasker E, Kansal S, Singh OP*, Malaviya P, Singh AK, Chourasia A, Singh T, Sudarshan M, Singh AP, Singh B, Singh RP, Ostyn B, Fakiola M, Picado A, Menten J, Blackwell JM, Wilson ME, Sacks D, Boelaert M, Sundar S. (2019). Determinants for progression from asymptomatic infection to symptomatic visceral leishmaniasis: A cohort study. PLoS Neglected Tropical Diseases 13(3):e0007216. doi:10.1371/journal.pntd. 0007216.

Singh OP, Hasker E, Boelaert M and Sundar S. (2016). Elimination of visceral leishmaniasis on the Indian Subcontinent. Lancet Infect Dis. 16(12):e304-e309. 

Cloots K, Uranw S, Ostyn B, Bhattarai NR, Le Rutte E, Khanal B, Picado A, Chappuis F, Hasker E, Karki P, Rijal S, Boelaert M ( 2020) Impact of the visceral leishmaniasis elimination initiative on Leishmania donovani transmission in Nepal: a 10-year repeat survey. Lancet Glob Health;8(2):e237-e243. doi: 10.1016/S2214-109X(19)30536-4.

Mondal D, Kumar A, Sharma A, Ahmed MM, Hasnain MG, Alim A, Huda MM, Rahman R, Alvar J, Ahmed BN, Haque R. (2019). Relationship between treatment regimens for visceral leishmaniasis and development of post-kala-azar dermal leishmaniasis and visceral leishmaniasis relapse: A cohort study from Bangladesh. 

BHU

Prof Shyam Sundar

Prof. Jaya Chakravarty

Dr. Om Prakash Singh

Dr. Paritosh Malaviya

Dr Sangeeta Kansal

ITM

Prof. Marleen Boelaert

Dr Epco Hasker

Dr Kristien Cloots

Dr. Rian Snijders

Banaras Hindu University, Varanasi, India (BHU)

Institute of Tropical Medicine, Antwerp, Belgium (ITM)

Bill and Melinda Gates Foundation (BMGF)